A 6 years trends in hospitalization: retrospective study of Traumatic Brain Injury

Abstract Introduction Traumatic Brain Injury (TBI) is a significant public health issue globally, and the mortality and morbidity burden is particularly high in low- and middle-income counties (LMICs). The WHO predicts a disproportionately large increase of TBI burden in LMICs. The aim of this study was to identify trends in hospitalization associated with TBI in Georgia from 2015-2020. Methods The study was designed in the framework of the project INITIatE: International Collaboration to Increase TBI Surveillance in Europe, funded by the US National Institutes of Health (NIH/NINDS R21NS098850). The surveillance database of National Center for Disease Control and Public Health of Georgia was used for the study. Results During the study period a total 51 147 patients were admitted in hospitals throughout the country. In 2015-2019 the hospitalization increased and highest number of cases was in 2019 (n = 11779; 23,0%), in 2020 hospitalization decreased in comparison with the previous year (n = 9228; 18,0%). The highest number of burn injuries (n = 22963; 45,0%) occurred in the capital of Georgia (Tbilisi). Among hospitalized patients about 61,0% were males (n = 31162) and 39,0% females (n = 19985), retrospectively with ratio 1,6:1. The modal age of hospitalized patients was 25-44 and the highest hospitalization was in the age group of 15-24. 92,5% of cases were unintentional. The leading cause of Traumatic Brain Injury in all years were falls with some variations (57%-71%), followed by road traffic injuries (12%-25%). The average of LOS was 3 days, the highest LOS was 702 days. 1,6% (n = 805) of patients died. The most common mechanism of fatal injuries were falls. Conclusions The study provide important information about trends in hospitalization, size of the TBI problem, which is crucial for elaborating relevant policy and establishing priorities in order to reduce the burden of Traumatic Brain Injury in Georgia, as well to identify directions for further TBI related research. Key messages • Epidemiological data are essential for designing relevant preventive programs. • Prevention is a key component of public health efforts to reduce TBI burden.


Introduction:
Traumatic Brain Injury (TBI) is a significant public health issue globally, and the mortality and morbidity burden is particularly high in low-and middle-income counties (LMICs). The WHO predicts a disproportionately large increase of TBI burden in LMICs. The aim of this study was to identify trends in hospitalization associated with TBI in Georgia from 2015-2020.

Methods:
The study was designed in the framework of the project INITIatE: International Collaboration to Increase TBI Surveillance in Europe, funded by the US National Institutes of Health (NIH/NINDS R21NS098850). The surveillance database of National Center for Disease Control and Public Health of Georgia was used for the study.

Results:
During the study period a total 51 147 patients were admitted in hospitals throughout the country. In 2015-2019 the hospitalization increased and highest number of cases was in 2019 (n = 11779; 23,0%), in 2020 hospitalization decreased in comparison with the previous year (n = 9228; 18,0%). The highest number of burn injuries (n = 22963; 45,0%) occurred in the capital of Georgia (Tbilisi). Among hospitalized patients about 61,0% were males (n = 31162) and 39,0% females (n = 19985), retrospectively with ratio 1,6:1. The modal age of hospitalized patients was 25-44 and the highest hospitalization was in the age group of 15-24. 92,5% of cases were unintentional. The leading cause of Traumatic Brain Injury in all years were falls with some variations (57%-71%), followed by road traffic injuries (12%-25%). The average of LOS was 3 days, the highest LOS was 702 days. 1,6% (n = 805) of patients died. The most common mechanism of fatal injuries were falls.

Conclusions:
The study provide important information about trends in hospitalization, size of the TBI problem, which is crucial for elaborating relevant policy and establishing priorities in order to reduce the burden of Traumatic Brain Injury in Georgia, as well to identify directions for further TBI related research. Key messages: Epidemiological data are essential for designing relevant preventive programs. Prevention is a key component of public health efforts to reduce TBI burden.

Introduction:
Falls are one of the major public health problems and a leading cause of injury-related morbidity and mortality globally. Around of 80% of fall deaths occur in low-and middleincome countries. Falls are the most common cause of hospitalization among the population aged 65 years and older. According the data from Global Burden of Disease (GBD) Study in Georgia, DALYs from falls exceed the average in LMICs. The aim of this observational study was to explore epidemiological characteristics of fall-related injury among hospitalized elderly patients in Georgia in 2020.

Methods:
This study was designed in the framework of the project iCREATE: Increasing Capacity for Research in Eastern Europe' funded by the NIH (2D43TW007261). All patients aged 65 and older admitted to hospital settings due fall-related injury in 2020 were identified from the Hospital Registry (included a total of 152 hospitals in the country) of the National Center for Disease Control and Public Health of Georgia.

Results:
A total of 7159 injured patients age 65 and above were admitted to hospitals in Georgia, and among them 4213 were hospitalized due to the falls (60%). Males comprised 30,7% of cases and females -69,3%. The most common source of hospital arrival was ambulance 2791 (65,0%), followed by private/public transport 1432 (33,3%). The highest number of injuries (43,5%) occurred in Tbilisi (capital of Georgia). The leading cause in fall-related hospitalization was fall on same level. Pelvis and the head were the most common body regions injured accounting for 48,0% and 22,9% of cases, respectively. The highest LOS was 2014 (SD 6,161). 111 patients died due to falls related injury during the study period.

Conclusions:
This study indicates that fall-related injury prevention among elderly population should become a key priority area in Georgia. There is a need for elaborating relevant preventive interventions of falls injuries in population aged 65 years and older.
Key messages: Falls are the leading cause of hospitalization of patients 65 years of age and older. Fall risk awareness campaigns should be the first step to fall prevention among elderly.